Worms are enemies in Crash Twinsanity, in which they appear green and bigger than natural worms with eyes and a mouth. These worms can be used as trampolines to get to high areas and such, and they are only found in holes, and only the heads are shown due to the hole. They attack by reaching out to bite the player. They makes their debut in the Belly Flop tutorial in Jungle Bungle, where Cortex (disguised as Coco) belly flops a worm (it is the only way to get them going through the ground) and it goes through the ground and pops out of another hole. Here, it is used to get up to a grassy stone platform, and when the worm is in it's original place, it is used to get the Green Gem which is located on a nearby column. After the stone platform is reached, the player must go through a series of three worms to get from platform to platform to reach a pathway.

They are later seen in Totem Hokum, where Crash must belly flop one worm throughout the whole native village to rescue Cortex, who is tied to a totem pole by Papu Papu. When Crash gets this worm close to the totem pole, he then must hop on it and hop towards the totem pole to rescue Cortex. Many of them are seen on N. Sanity Isle at Farmer Ernest's farm, where they have caused his Wumpa Trees to stop growing, so these worms will act as a sort of mini-game, where Crash, with Cortex at hand, must slam Cortex on the worms, thus flattening their faces. After 15 are squished, the Wumpa Trees grow and act as platforms for Crash and Cortex to carry on. And, if the player returns to this island, they will find a worm next to the cliff with Farmer Ernest's farm, in which this worm is used to get to. If Crash double jumps on a worm he will sprung up whilst being flopped on his back. Also, in Jungle Bungle, a picture of a Tribesman jumping on a worm can be seen just before Cortex gives Crash a tutorial on the belly flop.